Applied Nursing Research最新文献

{"title":"Graduate pathways following nursing education during COVID-19","authors":"Peter Fieger ,&nbsp;John Rice","doi":"10.1016/j.apnr.2024.151864","DOIUrl":"10.1016/j.apnr.2024.151864","url":null,"abstract":"<div><div>The COVID-19 pandemic has exerted many effects on populations worldwide. Due to the nature of the pandemic, health and specifically nursing sectors have been particularly impacted. While the nursing sector had to grapple with the impact of the pandemic as well as associated government interventions, nursing students have experienced changes in their job prospects, satisfaction with their training and their propensity to engage in further studies, all impinging on the sustainability of nursing education. This study aims to analyze educational outcomes for nursing graduates undertaking VET (vocational education and training) programs in Australia. Impacts assessed include employment, satisfaction, and further study after completion. The paper is based on analysis of five large waves of a comprehensive survey of Australian vocational education completers, from 2018 to 2022 inclusive. We develop three separate logistic regression models for the outcomes of employment, satisfaction, and enrollment in further study in order to estimate the predictive margins for the interactions between year and field of education, including the Diploma of Nursing, all other health qualifications, and all other qualifications. Our results show that these graduates saw significantly improved employment outcomes and heightened satisfaction during and after the pandemic, pointing to the sector meeting sustainability challenges. Interestingly, enrolment in further studies, after a notable increase earlier in the pandemic, returned to pre-pandemic levels as the crises abated.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"80 ","pages":"Article 151864"},"PeriodicalIF":2.7,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142529097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of personality, empathy, and the perception of the instructor's caring on nursing students' burnout: A cross-sectional study","authors":"Stefano Ardenghi ,&nbsp;Michela Luciani ,&nbsp;Selena Russo ,&nbsp;Giulia Rampoldi ,&nbsp;Marco Bani ,&nbsp;Davide Ausili ,&nbsp;Stefania Di Mauro ,&nbsp;Maria Grazia Strepparava","doi":"10.1016/j.apnr.2024.151863","DOIUrl":"10.1016/j.apnr.2024.151863","url":null,"abstract":"<div><h3>Aim</h3><div>The present study aimed to evaluate the contribution of personality, empathy, and the perception of instructor's caring in predicting burnout in nursing students.</div></div><div><h3>Background</h3><div>Burnout is alarmingly prevalent and rising among nursing students. Furthering our understanding of individual and clinical environmental antecedents of burnout is crucial to shield nursing students' well-being during their training.</div></div><div><h3>Methods</h3><div>In a cross-sectional study design, the Ten Item Personality Inventory (TIPI), the Brief version of the Interpersonal Reactivity Index (BIRI), the Nursing Students' Perception of Instructor Caring (NSPIC), and the Copenhagen Burnout Inventory (CBI) were administered to 361 (83.9 % females) Italian nursing students between July and December 2021. <em>t</em>-Tests, analyses of variance, Pearson's correlations, and hierarchical regressions were performed to examine the association of CBI with socio-demographics, TIPI, BIRI, and NSPIC.</div></div><div><h3>Results</h3><div>Being female and having a low household income were predictors of Personal Burnout and Work-related Burnout. Personal Burnout was positively associated with TIPI-Neuroticism and BIRI-Personal Distress. Work-related Burnout was positively associated with BIRI-Personal Distress and NSPIC-Control, and negatively associated TIPI-Openness to Experience, NSPIC-Support, NSPIC-Confidence. Client-related Burnout was negatively associated with TIPI-Agreeableness, NSPIC-Support, NSPIC-Confidence. Beyond the effect of socio-demographics, TIPI, and BIRI, NSPIC subscales significantly contributed to the explained variance in CBI scores.</div></div><div><h3>Conclusions</h3><div>Sex, household income, personality, and empathy should be considered when designing interventions to decrease burnout in nursing students. Promoting caring relationships between clinical instructors and their pupils may contribute to reduce nursing students' burnout.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"80 ","pages":"Article 151863"},"PeriodicalIF":2.7,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the effects of moral distress, compassion fatigue and burnout on intention to leave among nursing students in Hong Kong: A cross-sectional study","authors":"Winnie Lai-Sheung Cheng ,&nbsp;Anson Chui-Yan Tang ,&nbsp;Katherine Lai-Sheung Siu","doi":"10.1016/j.apnr.2024.151861","DOIUrl":"10.1016/j.apnr.2024.151861","url":null,"abstract":"<div><h3>Background</h3><div>Compassion fatigue and burnout have detrimental effects on nursing students. Moral distress has been recognized as a contributing factor to both, potentially impacting the intention to leave nursing programme.</div></div><div><h3>Aim</h3><div>To examine relationships among moral distress, compassion fatigue and burnout on intention to leave the nursing programme among nursing students.</div></div><div><h3>Methods</h3><div>A cross-sectional correlational design was used. Four hundred eighty-four nursing students from nine higher educations participated. Data were collected using the Moral Distress Scale-Revised, Compassion Fatigue Self-Test, and a single item examining the intention to leave.</div></div><div><h3>Results</h3><div>Mild to moderate levels of moral distress but high levels of compassion fatigue and burnout were reported. In regression analysis, year of study (OR = 14.323, CI = 1.273–161.143, p &lt; 0.031), length of clinical learning (OR = 1.061, CI = 1.020–1.103, p &lt; 0.003), moral distress (OR = 3.181, CI = 1.848–5.475, p &lt; 0.001), burnout (OR = 1.165, CI = 1.118–1.214, p &lt; 0.001) were associated with a higher chance of intention to leave. Attendance of an ethics course for &gt;30 h (OR = 0.164, CI = 0.041–0.653, p &lt; 0.010) and the interaction between moral distress and burnout (OR = 0.977, CI = 0.968–0.987, p &lt; 0.001) were associated with a significant decrease in the intention to leave.</div></div><div><h3>Conclusion</h3><div>Burnout is a strong predictor for intention to leave the nursing programme among nursing students. Interventions addressing moral distress, compassion fatigue, and burnout might prevent intention to leave the nursing programme.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"80 ","pages":"Article 151861"},"PeriodicalIF":2.7,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142529096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are male nurses oppressed? A forum theater application: A quasi-experimental study","authors":"Lütfiye Nur Uzun Asst. Prof.,&nbsp;Hümeyra Hançer Tok Asst. Prof.","doi":"10.1016/j.apnr.2024.151860","DOIUrl":"10.1016/j.apnr.2024.151860","url":null,"abstract":"<div><h3>Background</h3><div>Male nurses in clinical and educational settings are discriminated against. It is thought that perceiving the current situation of minority male nurses, who have the potential for social exclusion and oppression, and positively developing the perceptions of nursing students who are at the beginning of their professionalization lives, will contribute to the professionalization of future members of the profession.</div></div><div><h3>Objectives</h3><div>This study was conducted to find solutions to the current and potential difficulties experienced by male nurses, first-year nursing students, through a forum theater activity.</div></div><div><h3>Method</h3><div>The sample consisted of 24 first-year nursing students. Participants were given awareness training on male nurse discrimination using forum theater. Were given participants awareness training on male nurse discrimination using forum theater.</div><div>Research data student information form, Gender Attitudes of Nursing Students Towards the Nursing Profession Scale and were used for qualitative data participant opinion form.</div></div><div><h3>Results</h3><div>It was determined that the forum theater activity increased the awareness level of firstyear nursing students regarding gender attitudes towards the nursing profession. Students stated that participating in forum theater training was a real life experience in the learning process, that they were happy to participate in this training, and that participating in these events increased their self-confidence.</div></div><div><h3>Conclusion</h3><div>In this study, it was concluded that forum theater was effective in improving the awareness level of discrimination in the male nurse discrimination training given to nursing students. Forum theater can be used in nursing education.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"80 ","pages":"Article 151860"},"PeriodicalIF":2.7,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “A hybrid type 2 effectiveness-implementation design to evaluate a community-based, heart-healthy intervention for women of low-socioeconomic status” [Appl. Nurs. Res. 71, 2023, 151686]","authors":"Heidi Luft ,&nbsp;Roger Brown ,&nbsp;Diane Lauver","doi":"10.1016/j.apnr.2024.151859","DOIUrl":"10.1016/j.apnr.2024.151859","url":null,"abstract":"","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"80 ","pages":"Article 151859"},"PeriodicalIF":2.7,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142423040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in nutritional status and fatigue and their associations with quality of life in patients with pancreatic cancer after surgery: A 12-month longitudinal study","authors":"Ling-Fang Hsu ,&nbsp;Yun-Hsiang Lee ,&nbsp;Hui-Ying Yang ,&nbsp;Yun-Jen Chou ,&nbsp;Yu-Wen Tien ,&nbsp;Chieh-Yu Liu ,&nbsp;Shiow-Ching Shun","doi":"10.1016/j.apnr.2024.151858","DOIUrl":"10.1016/j.apnr.2024.151858","url":null,"abstract":"<div><h3>Objective</h3><div>This study examined changes in nutritional status, fatigue, and quality of life, and identified longitudinal factors influencing changes in quality of life in patients with pancreatic cancer before and 12 months after surgery.</div></div><div><h3>Methods</h3><div>A longitudinal, correlational, single-group study was conducted on 89 patients with operable pancreatic cancer in Taiwan. Data were collected preoperatively (T0) and at 3 (T1), 6 (T2), and 12 (T3) months post-surgery using questionnaires— Mini Nutritional Assessment, Fatigue Symptom Inventory, and Functional Assessment of Cancer Therapy-General—and through bioelectrical impedance analysis, handgrip strength measurement, and the 30-s sit-to-stand test. Generalized estimating equation models were used to analyze variable changes and associated factors.</div></div><div><h3>Results</h3><div>Body weight (T1, <em>p</em> &lt; 0.01; T2, <em>p</em> &lt; 0.01; T3, p &lt; 0.01), visceral fat mass (T1, p &lt; 0.01; T2, p &lt; 0.01; T3, p &lt; 0.01), and handgrip strength (T1, p &lt; 0.01; T2, p &lt; 0.01; T3, p &lt; 0.01) decreased significantly after surgery. The quality of life significantly improved at T2 and T3 (T2, <em>p</em> = 0.04; T3, p = 0.04). Lower visceral fat mass (β = −2.27, <em>p</em> &lt; 0.01), better overall nutritional status (β = 1.54, p &lt; 0.01), and lower fatigue (β = −0.26, p &lt; 0.01) were associated with higher quality of life from T0-T3.</div></div><div><h3>Conclusions</h3><div>Patients with pancreatic cancer should have their nutritional status and fatigue assessed early and continuously for at least 12 months post-surgery. Early preoperative interventions that can reduce visceral fat mass, combat malnutrition, and alleviate fatigue are recommended.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"80 ","pages":"Article 151858"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142423039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stress coping and resilience of frontline nurses under the emergency infectious disease pandemic: A latent class analysis","authors":"Yi-Chen Yeh ,&nbsp;Wang-Huei Sheng ,&nbsp;Mei-Yan Pan ,&nbsp;Hsiu-Yun Liu ,&nbsp;Chieh-Yu Liu ,&nbsp;Piao-Yi Chiou","doi":"10.1016/j.apnr.2024.151857","DOIUrl":"10.1016/j.apnr.2024.151857","url":null,"abstract":"<div><h3>Aim</h3><div>This study aimed to classify coping strategies and resilience among nurses caring for COVID-19 patients using latent class analysis (LCA), and to compare variations across these subgroups.</div></div><div><h3>Background</h3><div>The pandemic of emerging infectious diseases is a traumatic stressor for frontline nurses, potentially leading to compassion fatigue. Effective coping strategies and resilience were essential for managing stress, but their nuanced classification and outcomes remain unclear.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted from January to March 2022. Purposive and snowball sampling was utilized to recruit participants.</div></div><div><h3>Results</h3><div>A total of 215 clinical nurses (mean age 34.59 years) were recruited. A three-class model showed the best fit: class 1 (35.8 %) with proactive coping and high resilience, class 2 (29.8 %) with mixed coping and high resilience, and class 3 (34.4 %) with avoidance coping and low resilience. Compared to class 3, class 1 participants had lower stress (Odds Ratio (<em>OR</em>) = 0.37, 95 % <em>CI</em>: 0.143–0.950, <em>P</em> = 0.039), reduced risk of compassion fatigue (<em>OR</em> = 0.29, 95 % <em>CI</em>: 1.110–4.536, <em>P</em> &lt; 0.001), and lower intention to quit (<em>OR</em> = 0.39, 95 % <em>CI</em>: 0.175–0.843, <em>P</em> = 0.017). Class 2 participants, with higher proportion to live with family, had longer work experience, higher income, and also showed significantly reduced intention to quit (<em>OR</em> = 0.386, 95 % <em>CI</em>: 0.168–0.887, <em>P</em> = 0.025).</div></div><div><h3>Conclusions</h3><div>Identifying these vulnerable groups can help in providing interventions to reduce stress and prevent compassion fatigue and intention to quit.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"80 ","pages":"Article 151857"},"PeriodicalIF":2.7,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142423038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency department nurses' reflective thinking and patient safety competency: The mediating effect of patient safety culture","authors":"Mi Na Park MSN, RN ,&nbsp;Young Sook Roh PhD, RN","doi":"10.1016/j.apnr.2024.151856","DOIUrl":"10.1016/j.apnr.2024.151856","url":null,"abstract":"<div><h3>Aim</h3><div>This study aimed to identify the mediating effect of patient safety culture on the relationship between reflective thinking and patient safety competency in emergency department nurses.</div></div><div><h3>Background</h3><div>Given the complexity and the need for timely assessments and interventions in the emergency department, the patient safety competency of nurses is crucial for preventing safety incidents.</div></div><div><h3>Methods</h3><div>This study utilized a cross-sectional descriptive correlational design with a convenience sample of 200 emergency department nurses. Participants completed a web-based, self-administered questionnaire that assessed reflective thinking, patient safety culture, and patient safety competency. The percentile bootstrap method for mediation analysis was performed to ascertain the mediating role of patient safety culture in the relationship between reflective thinking and patient safety competency.</div></div><div><h3>Results</h3><div>Both reflective thinking and patient safety culture were significant predictors of patient safety competency. Furthermore, patient safety culture was found to mediate the relationship between reflective thinking and patient safety competency among emergency department nurses.</div></div><div><h3>Conclusions</h3><div>The findings suggest that emergency department nurses could benefit from a competency enhancement program or quality improvement projects that focus on reflective thinking and patient safety culture, which are significant predictors of patient safety competency.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"80 ","pages":"Article 151856"},"PeriodicalIF":2.7,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142423037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emotion recognition and clinical empathy: An observational study of nurses","authors":"Martin Shaw ,&nbsp;Annika Bilog ,&nbsp;Daniel Reyes ,&nbsp;Gudrun Klim ,&nbsp;Elizabeth Johnston Taylor","doi":"10.1016/j.apnr.2024.151855","DOIUrl":"10.1016/j.apnr.2024.151855","url":null,"abstract":"<div><h3>Aim</h3><div>To explore nurse ability to recognize emotion and its association with clinical empathy.</div></div><div><h3>Background</h3><div>Empathy is elemental to nursing care and positively effects patient and nurse outcomes, yet self-reported clinical empathy has declined over the past decade. One hypothesized contributor to the ability of a nurse to be empathic is whether they can recognize emotion, a phenomenon thus far unstudied among nurses.</div></div><div><h3>Methods</h3><div>This cross-sectional study used online survey methods to collect data from 166 licensed nurses employed in one of 22 hospitals in Florida, USA. The Geneva Emotion Recognition Test-Short Form (GERT-SF) measured behavioral empathy—the ability to identify 7 positive and 7 negative basic emotions from non-language-based audiovisual clips with actors expressing these emotions. The Jefferson Scale of Empathy-Health Professionals measured self-reported clinical empathy in patient care. Demographic and work-related factors were assessed with investigator-designed items. Descriptive and bivariate statistical analyses were employed.</div></div><div><h3>Results</h3><div>Although nurses self-reported very high clinical empathy, their ability to recognize emotions using the GERT-S tool was fair. Emotion recognition and clinical empathy were weakly correlated (<em>r</em> = 0.175, <em>p</em> = 0.024, 95 % CI = 0.02–0.32). The least recognized emotion for the participants to identify was anxiety. No demographic variables were associated with either emotion recognition or clinical empathy.</div></div><div><h3>Conclusions</h3><div>These findings expose how nurse perceptions of being empathic may poorly align with the ability to recognize a patient's emotional response. Thus, findings have implications for teaching empathy, as well as for how researchers validly and reliably measure these constructs.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"80 ","pages":"Article 151855"},"PeriodicalIF":2.7,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142311217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Online recruitment for an online survey study: Our experience of dealing with fraudsters","authors":"Fang Lei","doi":"10.1016/j.apnr.2024.151854","DOIUrl":"10.1016/j.apnr.2024.151854","url":null,"abstract":"<div><h3>Background</h3><div>Online recruitment is cost efficient and can reach large sample size. It helps protect participants' privacy and confidentiality and is commonly used in research studies with sensitive topics and hard-to-reach target participants. However, widespread fraudulent responses along with missing data and multiple entries add complication to the data cleaning and analysis. This clinical-methods-brief described our experience of dealing with fraudsters in the recruitment process of an online study.</div></div><div><h3>Methods</h3><div>Based on our experience in an online cross-sectional survey study, we reported three methods used in the recruitment process, including website recruitment (<span><span>https://www.chineseinla.com/</span><svg><path></path></svg></span>), Facebook advertisement, and Facebook group recruitment.</div></div><div><h3>Results</h3><div>The detected fraudulent rates were 11.11 %, 4.55 %, and 82.69 % for website recruitment, Facebook advertisement, and Facebook group recruitment, respectively. Strategies for us to identify the fake responses mainly included internet protocol checking, conflict answers to different survey questions, participant's name, and time stamp checking.</div></div><div><h3>Discussion</h3><div>Fake data mixed in the research data threatens the validity and reliability of the study and may skew the research study results. A robust participant recruitment method and a data screening/cleaning protocol are necessary to ensure online studies' rigorous.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"80 ","pages":"Article 151854"},"PeriodicalIF":2.7,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142311218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}